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In re Steven P.

September 25, 2003

IN THE MATTER OF STEVEN P., A PERSON FOUND SUBJECT TO INVOLUNTARY TREATMENT,
THE PEOPLE OF THE STATE OF ILLINOIS, PETITIONER-APPELLEE,
v.
STEVEN P., RESPONDENT-APPELLANT.



Appeal from Circuit Court of Champaign County No. 02MH44 Honorable Michael Q. Jones, Judge Presiding.

The opinion of the court was delivered by: Presiding Justice Myerscough

UNPUBLISHED

In November 2002, the State named respondent, Steven P., in a petition for involuntary administration of drugs and the use of electroconvulsive therapy (ECT) due to his mental condition. Following a hearing, the trial court granted the petition authorizing ECT and involuntary administration of medication.

On appeal, respondent argues (1) the State failed to prove by clear and convincing evidence that less-restrictive services other than ECT were inappropriate to treat his condition, and (2) he was not advised in writing of the side effects, benefits, and alternatives to the proposed treatment. We affirm.

I. BACKGROUND

In November 2002, the State named respondent in a petition for administration of authorized involuntary treatment based on his suffering from a serious mental illness, namely, bipolar affective disorder with psychotic symptoms and manic state. Because of his illness, respondent exhibited deterioration of his ability to function, remained delusional, and was unable to weigh the risks and benefits of treatment, and his intermittent use of medication had not improved his symptoms. In the petition, Dr. Hayng-Sung Yang found respondent to be in need of involuntary treatment because the benefits of treatment outweighed the harm, he lacked the capacity to make a reasoned decision about treatment, and other, less-restrictive services were explored and found inappropriate. Dr. Yang indicated the administration of ECT and psychotropic medication were essential for the safe and effective administration of treatment.

The trial court conducted a hearing on the petition. Dr. Yang testified he has been a psychiatrist since 1974. He stated respondent came under his care at the Provena Covenant Medical Center psychiatric unit about three weeks prior to the hearing. During his care, Dr. Yang found respondent to be "religiously delusional," believing himself to be in perfect health. Respondent thinks he is depressed while "showing [a] rather elated, excited, [and] irritable mood." Dr. Yang diagnosed respondent with manic depression, a manic condition with psychotic symptoms. Respondent did not show much improvement because he did not regularly take his medication. Dr. Yang opined respondent's mental illness rendered him incapable of rationally weighing the risks and benefits involved in the treatment options available to him.

Dr. Yang recommended ECT, which he stated is used when a patient is extremely depressed, suicidal, or suffering from a manic condition. Dr. Yang stated respondent had no other alternative because he refused to take oral medication, such as Depakote, lithium, and Tegretol, to improve his manic condition. He also sought court authority to administer a number of drugs, including Zyprexia (a mood stabilizer), lithium carbonate, Depakote, Haldol Decanoate, and Cogentin (to alleviate the side effects of Haldol).

Respondent testified he no longer needed Depakote or lithium, but instead he needed to go home and have "more home cooking." He stated he was forced to take pills every day and suffered from screaming, throwing up, and shaking in the night. Respondent indicated the lithium "makes [his] mind unclear." Further, he had ECT about five years ago and it "helped [him] somewhat."

The State sought authority to administer for 90 days ECT for a maximum of 12 times, Zyprexia, lithium carbonate, Depakote, Cogentin, Haldol Decanoate, general anesthesia, re-straints, and blood tests. The trial court found by clear and convincing evidence that respondent has a serious mental illness, exhibiting a deterioration of his ability to function that existed for a period of time marked by the continuing presence of the symptoms. The court also found the benefits of the treatment outweighed the harm and other, less-restrictive services were explored and found inappropriate. The court then authorized the administration of ECT and the various medications. Following the appointment of the Guardianship and Advocacy Commission as respondent's counsel, this appeal followed.

II. ANALYSIS

Respondent argues the State failed to prove by clear and convincing evidence that he lacked the capacity to make a reasoned decision about his treatment because he was not advised in writing of the side effects, risks, benefits, and alternatives to the proposed treatment as required by law. We disagree even though the State concedes this issue.

To administer authorized involuntary treatment, the State must prove by clear and convincing evidence that, inter alia, the recipient lacks the capacity to make a reasoned decision about the treatment. In re Edward S., 298 Ill. App. 3d 162, 166, 698 N.E.2d 186, 188 (1998). When reviewing the sufficiency of the evidence, the trial court's decision will be reversed only if it is against the manifest weight of the evidence. In re Richard C., 329 Ill. App. 3d 1090, 1094, 769 N.E.2d 1071, 1075 (2002). "A judgment is against the manifest weight of the evidence when the opposite conclusion is clearly evident, plain, and indisputable." In re Cathy M., 326 Ill. App. 3d 335, 341, 760 N.E.2d 579, 585 (2001).

Section 2-107.1(a)(4)(E) of the Mental Health and Developmental Disabilities Code (Code) provides the State must prove the respondent lacked the capacity to make a reasoned decision about the treatment. 405 ILCS 5/2-107.1(a)(4)(E) (West 2000). A necessary predicate to making this informed decision is that the respondent must be informed of the risks and benefits of the medication ...


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